title: Transcatheter and endovascular stent graft management of coarctation-related pseudoaneurysms.
abstract: OBJECTIVE
  Surgical correction of congenital aortic coarctation can lead to a number of important problems including late pseudoaneurysm formation. Redo surgery has a significant risk. Endovascular stent graft repair is increasingly used but there are limited data regarding this indication. We describe the experience of two UK congenital referral centres.
  
  
  METHODS
  Retrospective analysis of patients treated with endovascular aortic stent grafting for late pseudoaneurysms.
  
  
  METHODS
  Two UK congenital heart centres, Bristol Heart Institute and Leeds General Infirmary.
  
  
  METHODS
  17 patients were treated 2006-2012. This represents all patients treated with this technique.
  
  
  METHODS
  Procedural and postprocedure success and complications.
  
  
  RESULTS
  The average time from index repair to endovascular repair of pseudoaneurysm was 24.6 years. The majority (70.6%) had patch aortoplasty as the original surgical procedure and 41.2% were not under follow-up or discharged. Stent grafting procedural success rate was 100%. Median hospital stay postprocedure was 3 days. There was no procedural mortality or immediate complication. There were four minor early and three minor late complications. Imaging follow-up was available for an average of 31.6 months (range 6-65 months). All patients have demonstrated positive remodelling of the pseudoaneurysm with no incidence of continued expansion or stent graft failure up to 5 years following implant.
  
  
  CONCLUSIONS
  Endovascular stent graft treatment of pseudoaneurysms show promising results in a population who have a high risk of surgical re-intervention. Complication rates appear to be low and recovery is quick. Longer-term data remain essential to scrutinise stent graft performance in this situation.
authors.affiliation: Department of Cardiology, The Bristol Heart Institute, University Hospitals Bristol NHS Foundation Trust, Bristol Royal Infirmary, Bristol, UK. khavandi@hotmail.com
authors.forename: A
authors.initials: A
authors.lastname: Khavandi
authors.forename: J
authors.initials: J
authors.lastname: Bentham
authors.forename: M
authors.initials: M
authors.lastname: Marlais
authors.forename: R P
authors.initials: RP
authors.lastname: Martin
authors.forename: G J
authors.initials: GJ
authors.lastname: Morgan
authors.forename: A J
authors.initials: AJ
authors.lastname: Parry
authors.forename: M J
authors.initials: MJ
authors.lastname: Brooks
authors.forename: N E
authors.initials: NE
authors.lastname: Manghat
authors.forename: M C K
authors.initials: MC
authors.lastname: Hamilton
authors.forename: A
authors.initials: A
authors.lastname: Baumbach
authors.forename: S
authors.initials: S
authors.lastname: McPherson
authors.forename: J D
authors.initials: JD
authors.lastname: Thomson
authors.forename: M S
authors.initials: MS
authors.lastname: Turner
mesh_terms: D000328:Adult; D000368:Aged; D017541:Aneurysm, False / Q000000981:diagnostic imaging / Q000209:etiology* / Q000601:surgery; D001017:Aortic Coarctation / Q000150:complications* / Q000000981:diagnostic imaging / Q000601:surgery; D019917:Blood Vessel Prosthesis Implantation / Q000009:adverse effects / Q000379:methods* / Q000401:mortality; D057510:Endovascular Procedures / Q000009:adverse effects / Q000379:methods* / Q000401:mortality; D005260:Female; D006801:Humans; D008297:Male; D011183:Postoperative Complications / Q000401:mortality; D012189:Retrospective Studies; D015607:Stents; D014057:Tomography, X-Ray Computed; D019737:Transplants; D016896:Treatment Outcome; D006113:United Kingdom
keywords: Congenital Heart Disease